We report the case of a 45-year-old woman with recalcitrant perioral dermatitis resistant to multiple topical and systemic therapies who achieved complete remission following treatment with oral isotretinoin. The patient presented with persistent periorificial papules despite ivermectin-based topical regimens, calcineurin inhibitors, compounded anti-inflammatory formulations, and repeated courses of doxycycline. Sustained disease control was achieved with low-dose isotretinoin maintenance therapy. This case highlights the therapeutic challenges associated with refractory perioral dermatitis and supports the potential role of isotretinoin as an antibiotic-sparing strategy in selected patients.
Guarda et al. (Thu,) studied this question.